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Lack of leadership hurts Ebola fight in West Africa: MSF

By Stephanie Nebehay

GENEVA (Reuters) - Efforts to curb the deadly Ebola epidemic that swept across four West African states are being undermined by a lack of leadership and emergency management skills, the international head of Medecins sans Frontieres (MSF) said on Thursday.

In an interview, Joanne Liu also said the world's worst ever outbreak of Ebola has caused widespread panic and the collapse of health care systems particularly in Liberia, where pregnant women have lost babies while seeking a safe place to deliver.

She said Western nations must dispatch more experts in tropical medicine, especially field workers who know how to help communities prevent the often lethal virus from spreading.

And the World Health Organization (WHO) must fulfill its leading role in coordinating the international response to the epidemic, the president of the global, Swiss-based medical charity told Reuters by telephone.

"I think they are in the process of bringing more people from the WHO but the reality is that this epidemic will be not be contained unless there are more players," Liu said.

"We are missing everything right now. We are missing a strong leadership centrally, with core nation capacity and disease emergency management skills. It's not happening."

The infectious disease has killed 1,350 people among 2,473 cases in four countries - Guinea, Liberia, Nigeria and Sierra Leone, according to the United Nations health agency.

MSF (Doctors Without Borders) has deployed 1,000 of its own staff in the stricken region, running centers that currently have 300 beds, according to Liu who spent 10 days in Guinea, Liberia and Sierra Leone earlier this month.

"All of our centers are overcrowded right now. We have an Ebola center in Lofa county in Foya (Liberia) which is close to the epicenter. It was meant to be a center with a capacity of 20 beds. We have more than 125 patients right now," Liu said.

"The same thing with our center in Monrovia, which we opened only last weekend, with 125 beds and now it's already filled.

We're entertaining the idea of increasing the capacity, if not doubling it," she said.

"GLOBAL FEAR IN LIBERIA"

Security forces in the Liberian capital fired live rounds and tear gas on Wednesday to scatter a stone-throwing crowd trying to break an Ebola quarantine imposed on their neighborhood.

"We are right now, I would say, in a state of global fear in Liberia," Liu said.

"It's paramount now to re-establish access to basic health care. Because we might be facing the ridiculous situation of having people dying more of non-Ebola pathologies than from Ebola. Right now in Monrovia for example, if you have malaria, nobody knows where to go and consult (for health care)."

Liu said that she had received an email from MSF staff with a sad and telling tale of pregnant women in Monrovia seeking a health care center where they could safely give birth.

"We had this week six pregnant women who ended up walking for hours in the city trying to find a place to deliver and by the time they got to our center, which was not the right place to be, the babies had died in their wombs," she said.

"I find this identifies very well what we are facing in terms of having a health care system being collapsed from the Ebola epidemic."

Western and African experts are needed to help with education to prevent spread of Ebola, trace contacts of infected people, and care for those in isolation wards, she added.

The U.S. Centers for Disease Control (CDC) is sending some 55 epidemiologists, but more are needed, Liu said.

"The U.S., Canada, France, Germany, those big nations who have big schools of tropical disease, who have know-how in working in highly contagious set-ups, who can mobilize, who have money," Liu said.

"But the reality is that all of us today are navigating in unknown waters. We've never faced something as big as this in the whole history of Ebola, it has never been as big, we have never faced Ebola in an urban setting."

(Editing by Mark Heinrich)

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